Acceptance

I’m sick.

It takes a lot for me to write this. It kind of feels like a blow to my ego or defeat of some sort. It feels unacceptable. I am 34. I am a mom to three and a puppy, a wife and a full-time doctor. How can I be sick? It’s not allowed… in my head.

This is not your typical illness. I’m not sure what that means, but this is not an understandable, quickly treatable, known illness. It is not an illness where I can even function to my general capacity. In my own history of illnesses, there has been predictability. There has been confidence that there would be quick improvement. There has been a day or so of feeling yucky, followed by full rebound. Not this time.

I was diagnosed with Long COVID a few weeks ago. My immediate thoughts were mixed. I had suspected it at times, but when I fully recovered from my symptoms at various times over the last two years, this diagnosis seemed unlikely. I figured COVID kind of just screwed up my immune system, and colds hit me harder for a while.

It turns out, long COVID is just that. The higher powers of doctor organizations are now grouping long COVID into three categories. There are those who have persistent, lingering symptoms for months and now, years. There are those that were hospitalized for months and have significant disabilities related to that, and then there are those like me, who have relapsing symptoms.

I call my initial COVID illness mild. I was never hospitalized. I never had respiratory symptoms. I have always downplayed this when asked. “Oh yes, I had it BUT it was mild.”

In comparison to hundreds of thousands (probably more) with more severe symptoms, yes it was mild. For my own little world and body and general equilibrium, it was not.

I spent a good 2-3 weeks in bed. When the mere thought of getting myself a glass of water exhausted me. It was horrible, terrible, debilitating. BUT – I recovered! I completely recovered. Last spring, I was in the best shape of my life. I was running miles on my Peloton and chasing around my children with ease. I was very happy, and I felt amazing.

What happened? I don’t know. I have theories. I have theories upon theories upon theories. My mind is racing to medical school days of immunology and the immune cascade, of T cell and B cells and innate versus cellular immunity. Maybe my T cell response and lingering immunity to COVID are so intense that any similar pathogen or trigger like vaccination activates them and they go wild, making me feel like utter crap. That is reigning theory number 1, but I have many.

The thoughts never stop. Why this? Why this symptom? Could it be psychosomatic? Is this just depression? Why am I so tired? Why can’t I snap out of it?

The reality is – as much as I want an answer and a quick fix, it’s not those things. I know depression is not the route cause. Sudden depression did not cause me to suddenly feel extreme fatigue, constant muscle aches and a terrible feeling of skin burning. Sudden depression did not cause me to have a positive coronavirus nasal swab at the height of my symptoms (yes – I suspect that likely triggered this). As a doctor, depression and anxiety can be an easy answer for unexplained, vague symptoms. All the tests are normal, it must be psychosomatic. It’s not.

One point of silver lining is that this knowledge alone will make me stronger. I have a newfound respect and appreciation for patients with chronic, difficult to manage, poorly studies illnesses. Sometimes, validation and understanding alone can mean the world to that person.

I want to go downstairs and run on my treadmill. I want to hold my beautiful 3-month-old baby. I want to go to work. I love my job. I want to feel highly functional again. I want to say see you later to the muscle aches, skin burning and extreme fatigue forever. I want my equilibrium back.

Yes – this IS depressing. Yes, feeling utterly exhausted and unable to do normal daily things is horrible and is likely making me depressed, but my mind is strong. My mind is my own, and I know that my mental health is not driving this.

I have always been open with my emotions, and I am not afraid to admit to low points. I certainly had bouts of depression or ‘baby blues’ after all three of my children were born. To be frank with you, I think most mothers do. It is a crazy time of incredible selflessness, hormonal shift and sleep deprivation. It will do things to you. Despite that, I was always aware of it. I was able to recognize it and bounce back quickly.

Right now, it feels like my equilibrium is off. My baseline of high energy, no pain, clear-headed thinking is nowhere in sight. I am yearning for it. I am praying for a return to my prior normalcy. Every morning, I wake up and hope I will jump out of bed and start the day as my prior self. This has been my mentality for the last 1-2 weeks, and when I wake up with exhaustion, it is very discouraging.

I have decided to shift to acceptance. I understand that I may never get that prior equilibrium, although I am also optimistic that I will. I have before. I acknowledge the good. I know that I am in a much better state than many. I know that I am very fortunate. I know that I have an amazing support system. My husband and mother have selflessly taken over all of my responsibilities, while also incredibly caring for me.

My husband has been so calm and understanding. He has reminded me that I will get better, but it will take time. He has reminded me to take the time. He emphasizes that there does not need to be a dedicated time frame right now. “Take it day-by-day,” he says. For this type A planner, that is a very, very difficult task.

My mother has also reminded me that it is OK to take time to get better. It is OK to be sick. She knows me, and she knows how much this is affecting me. I am quite defensive of my symptoms, as they are not obvious to a passing eye. I do not have an identifiable broken bone disabling me or grossly abnormal blood work hospitalizing me, but I am still sick. My mom knows this without any defense needed. She knows it is not psychosomatic or driven by mental health. She knows something is really wrong. She knew to immediately stop an antidepressant after it was recommended by my health team. I was willing to try anything to bounce back, but when I started to feel like my mind was not my own and had thoughts that were not my own, I was forced to stop it. She already knew this was not the answer.

I felt compelled to write today because I needed this outlet. I am also celebrating the fact that I had the energy to sit down and write this. Last week I could barely reply to a text message due to the exhaustion. I am improving, but it is very slow. I know I will get better.

I woke up in the middle of the night to feed my baby. I helped get the kids ready for school this morning. There was some yelling to do things and some chaos, but I was up and out of bed. I felt such happiness to have the strength to participate in life. These continue to be steps towards recovery and small accomplishments.

Today I need to remind myself of the need for acceptance. Acceptance of this illness. Acceptance that this is not my fault. Acceptance that I will improve. Acceptance that I need to give my body time to heal. Acceptance that all of the science and pathology is not yet understood, but that it will be once day. Acceptance that my job will still be waiting for me when I recover. Acceptance that I will run miles once again.